S1539
Interdisciplinary - Quality assurance and risk management
ESTRO 2026
10.1016/j.clon.2024.103735. Keywords: RTTQA, Radiotherapy QA, Oesophageal Radiotherapy
intent). Results:
Of the 755 consecutive patients reviewed, the multidisciplinary peer-review program identified deviations requiring adjustment in 11.7% of cases (n=88). Specifically, Minor Changes were necessary for 9.3% of the cohort (n=70), while Major Changes were required in 2.4% of cases (n=18). The vast majority of cases, 88.3% (n=667), were deemed optimal and required no change.
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Effectiveness and Impact of a Multidisciplinary Peer-Review Program on Quality Assurance in Radiation Oncology KARTHIKEYAN KALYANASUNDARAM 1 , SURENDRAN JAGADEESAN 2 , MAJED ALGHAMDI 1,3 , Yousra Naduthodi 1,4 , Yoginee Sonawane 1,4 , Moaz Mohammed 1 , Khulood Alameri 1 , Raad Sweidan 1 , Alaa Abdelqader 1 , Humaid O Alshamsi 5,6 , Ibrahim Abugheida 1,4 1 Radiation oncology, Burjeel medical city, Abudhabi, UAE. 2 Radiation oncology, Burjeel medical city, abudhabi, UAE. 3 College of Medicine, King Saud Bin Abdulaziz University, Jeddah, Saudi Arabia. 4 Emirates oncology society, EOS, Dubai, UAE. 5 Medical Oncology, Burjeel Cancer Institute, Abudhabi, UAE. 6 Dept of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA Purpose/Objective: Modern radiation oncology relies on stringent treatment protocols to guide complex planning. However, even with rigorous technical Quality Assurance (QA), subjective clinical steps—like target delineation—remain vulnerable to variation and error [1,2]. Therefore, validation by a multidisciplinary team (MDT) remains a crucial safety standard [3]. This study quantifies the effectiveness of our universal MDT peer review program in identifying and analysing clinically significant planning deviations Material/Methods: Addressing the inherent risks associated with complex multi-step planning and rapidly evolving technology, our standardised peer-review program was formally established in early 2024. It is applied universally to all clinical cases, irrespective of treatment intent or complexity. A dedicated multidisciplinary team comprising Radiation Oncologists, Medical Physicists, Senior Radiation Therapists, and Specialised Nurses conducts the review. Key discussion points include the evaluation of treatment volumes (target and OARs), dose prescription, and overall plan dosimetry. We retrospectively analysed 755 consecutive patients who completed this review process. Outcomes were systematically classified based on the level of clinical intervention required: No Change (plan deemed optimal), Minor Change (adjustments for documentation or technical precision without altering dose/intent), and Major Change (substantial modifications to volume definition, prescription, or dose distribution that significantly affected clinical
The average combined deviation rate (Major + Minor) was approximately 4.6 cases per month (12% of all cases reviewed monthly). A statistically significant increase in the overall deviation rate was observed in 2025 (p < 0.05), suggesting potential shifts in case complexity or operational processes. Furthermore, the analysis revealed distinct temporal patterns: Major deviations increased notably in 2025, and Minor deviations exhibited seasonal peaks during the periods of May–July and November–December. Conclusion: The implementation of a universal, multidisciplinary peer-review program is effective in identifying clinically significant deviations, particularly the 2.4% of cases requiring major Change. The detection of statistically significant temporal trends underscores the need for continuous process monitoring and quality assurance in radiation oncology. These findings affirm the peer- review process as a critical mechanism for mitigating risk and guaranteeing patient safety within complex treatment workflows References: 1) Marks, L.B., et al.2013. Enhancing the role of case- oriented peer review to improve quality and safety in radiation oncology: Executive summary. Pract Radiat oncol, 3(3), 149-156.2) Hoopes, D.J., et al. (2015). Practice patterns for peer review in radiation
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